Background: Frailty is a physiological condition characterized by a decreased reserve to stressors. In patients with COVID-19, frailty is a risk factor for in-hospital mortality. The aim of this study was to assess the relationship between clinical presentation, analytical and radiological parameters at admission, and clinical outcomes according to frailty, as defined by the Clinical Frailty Scale (CFS), in old people hospitalized with COVID-19. Materials and methods: This retrospective cohort study included people aged 65 years and older and admitted with community-acquired COVID-19 from 3 March 2020 to 31 April 2021. Patients were categorized using the CFS. Primary outcomes were symptoms of COVID-19 prior to admission, mortality, readmission, admission in intensive care unit (ICU), and need for invasive mechanical ventilation. Analysis of clinical symptoms, clinical outcomes, and CFS was performed using multivariable logistic regression, and results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of the 785 included patients, 326 (41.5%, 95% CI 38.1%–45.0%) were defined as frail (CFS ≥ 5 points): 208 (26.5%, 95% CI 23.5%–29.7%) presented mild-moderate frailty (CFS 5–6 points) and 118 (15.0%, 95% CI 12.7%–17.7%), severe frailty (7–9 points). After adjusting for epidemiological variables (age, gender, residence in a nursing home, and Charlson comorbidity index), frail patients were significantly less likely to present dry cough (OR 0.58, 95% CI 0.40–0.83), myalgia-arthralgia (OR 0.46, 95% CI 0.29–0.75), and anosmia-dysgeusia (OR 0.46, 95% CI 0.23-0.94). Confusion was more common in severely frail patients (OR 3.14; 95% CI 1.64-5.97). After adjusting for epidemiological variables, the risk of in-hospital mortality was higher in frail patients (OR 2.79, 95% CI 1.79-4.25), including both those with mild-moderate frailty (OR 1.98, 95% CI 1.23-3.19) and severe frailty (OR 5.44, 95% CI 3.14-9.42). Readmission was higher in frail patients (OR 2.11, 95% CI 1.07–4.16), but only in mild-moderate frailty (OR 2.35, 95% CI 1.17–4.75).. Conclusion: Frail patients presented atypical symptoms (less dry cough, myalgia-arthralgia, and anosmia-dysgeusia, and more confusion). Frailty was an independent predictor for death, regardless of severity, and mild-moderate frailty was associated with readmission.

Background and Objective: The aim of this study was to analyze sex differences in risk factors associated with hospital mortality in patients with Fournier gangrene (FG). Materials and Methods: A retrospective population-based study (2016–2021) included FG hospitalizations in Spain. To identify the risk factors, we used multivariable logistic regression and reported adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: There were 3644 admissions for FG during the study period (82.5% men and 17.5% women). The mean hospitalization rate per 1000 admissions/year was 0.23 for men and 0.05 for women, and the mean hospitalization rate per 100,000 inhabitants/year was 2.7 for men and 0.4 in women. The most common comorbidities were hypertension (44.9%) and diabetes mellitus (35.6%). The main complications were sepsis (22.1%), 29.8% were admitted to the intensive care unit and 16.1% died. Mortality was higher in women (aOR 1.32, 95% CI 1.07–1.63). The main independent risk factors for mortality in the entire sample were older age, neoplasms, chronic kidney disease, heart failure, sepsis, acute kidney injury, and admission to the intensive care unit. In women, they were older age, leukemia, sepsis, acute kidney injury, and admission to the intensive care unit. Conclusions: The overall FG mortality rate was slightly higher in women than in men, people aged >64 years, people with chronic kidney disease, sepsis, and acute kidney injury, and admission to the intensive care unit. The independent factors associated with mortality in women were similar in both sexes.

Background and Objectives: The aim of the following cross-sectional study is to determine the association between human leukocyte antigen (HLA) alleles and outcomes in patients presenting to the emergency department (ED) with SARS-CoV-2 infection. Methods and Materials: Genotyping was made using the Axiom Human Genotyping SARS-CoV-2 Research Array. Statistical analysis was made with Fisher’s exact test and multivariable logistic regression, adjusted for sex, age and clinical variables. Results: Of 190 patients, 11.1% were discharged from the ED; 57.9% were admitted to the COVID-19 ward, without intensive care unit (ICU) admission; 15.3% survived an ICU admission; and 15.8% died. After multivariable analysis, two HLA alleles protected against hospital admission (HLA-C*05:01, adjusted odds ratio [aOR] 0.2, 95% confidence interval [CI] 0.055–0.731; and HLA-DQB1*02:02, aOR 0.046, CI 0.002–0.871) and one was associated with higher risk for ICU admission or death (HLA-DQA1*05:01, aOR 2.517, CI 1.086–5.833). Conclusions: In this population, HLA-C*05:01 and HLA-DQB1*02:02 are associated with a protective effect against hospital admission and HLA-DQA1*05:01 is associated with higher risk of ICU admission or death in the multivariable analysis. This may help stratify risk in COVID-19 patients.

Presentamos el caso de un varón de 66 años, sin antecedentes de interés, que ingresa en Neurología por alteración subaguda de la marcha y visión borrosa. En el fondo de ojo se objetiva papiledema bilateral. En la electroneurografía se detecta una polineuropatía sensitivomotora de predominio axonal. En las pruebas de imagen se encuentra una masa pulmonar izquierda, con diagnóstico histológico de neoplasia. Los anticuerpos antineuronales en suero son positivos a anti-CV2 (collapsin response mediator protein [CRMP5]). El paciente es diagnosticado de polineuropatía sensitivomotora simétrica distal y neuropatía óptica anterior bilateral de origen paraneoplásico, secundario a cáncer microcítico de pulmón.

Ofatumumab, an anti-CD20 monoclonal antibody, is a high-efficacy disease-modifying therapy for relapsing multiple sclerosis (RMS). Although pivotal trials demonstrated substantial benefits, real-world data are required to confirm treatment persistence, effectiveness, safety, and biological markers of response in routine clinical settings. This study evaluated the real-world outcomes of ofatumumab in patients treated at a specialised multiple sclerosis (MS) centre in southeastern Spain, including exploratory analyses of B cell kinetics, comorbidity burden using the Charlson Comorbidity Index (CCI), and ethnicity. A retrospective observational study was conducted in adults with MS initiating ofatumumab between December 2022 and December 2025, with ≥ 6 months of continuous therapy. Demographic, clinical, radiological, laboratory, and pharmacological data were extracted from electronic medical records. Statistical analyses encompassed Kaplan-Meier estimates. Eighty-seven patients were included (mean age 43 years; 75.9% female; 88.5% relapsing-remitting phenotype). Over a median 22-month follow-up, treatment persistence was 95.4%. Annualised relapse rate (ARR) declined from 0.48 pre-treatment to 0.03 on treatment. No evidence of disease activity (NEDA-3) was achieved in 93.1%, with no significant differences between treatment-naïve and previously treated patients. Sustained CD19⁺ B cell depletion was confirmed in all assessments. Immunoglobulin levels remained mostly stable. Ofatumumab was generally well tolerated: systemic injection-related reactions occurred in 29.9% and infections in 6.9%. Exploratory analyses showed no significant differences in relapse or magnetic resonance imaging outcomes by CCI category or ethnicity. In this Spanish real-world single-centre cohort, ofatumumab demonstrated high persistence, substantial suppression of inflammatory activity, and a favourable safety profile in routine clinical practice. Sustained B cell depletion aligned with clinical and radiological stability. These findings support the real-world effectiveness of ofatumumab across diverse patient profiles and complement evidence from pivotal trials. Further prospective studies with broader populations and longer follow-up are warranted to refine understanding of long-term outcomes and determinants of treatment response variability.

Objectives: The aim of the following study is to determine the association between lymphocyte subsets (total lymphocytes, CD3, CD4, CD8, B cells, NK cells) and clinical outcomes (need for non-invasive ventilatory support, ICU admission and in-hospital death) in patients hospitalized with SARS-CoV-2 infection. Methods: We conducted a single-center, pre-vaccination, retrospective cohort study including adults hospitalized between March 2020 and April 2021. Peripheral blood samples were collected within the first 24 h of admission for immune phenotyping. Additional clinical data were obtained from electronic health records. Statistical analyses included chi-square tests and multivariable logistic regression, adjusted for clinical characteristics and inflammatory biomarkers. Optimal cutoff points for immune and inflammatory markers were determined using the Youden index. Results: Among 959 patients, 29.4% required ventilatory support, 11.3% required ICU admission, and 10.7% died. In multivariable analysis adjusted by clinical and laboratory confounders, CD3+ cells (cutoff point: 666 cells/mm ³ ) were independently associated with ventilatory support (aOR: 2.3, 95%CI: 1.5–3.4, p = 0.013) and in-hospital death (aOR: 2.4, 95%CI: 1.3–4.3, p = 0.048); and CD4+ cells (cutoff point: 359 cells/mm ³ ) were independently associated with in-hospital death (aOR: 2.8, 95%CI: 1.4–5.5, p = 0.045). Conclusion: Adaptive immunity, especially T CD3+ and T CD4+ cells, is relevant in the prognosis of COVID-19, and T-cell counts can help identify hospitalized COVID-19 patients at risk for severe outcomes: ventilatory support and in-hospital death.